According to Marta & Kawiyana (2016), an acute ankle sprain can be successfully treated using individualized, aggressive, and non-operative measures. While the patient may have taken two tablets of acetaminophen 325 mg, this drug alone cannot relieve the pain caused by the ankle sprain (Al-Mohrej & Al-Kenani, 2016). I would, therefore, prescribe a much stronger pain-relieving medication, that is, celecoxib 100 mg, which is a COX-2 NSAID. I would select this drug because it is useful for relieving acute (short-term) pain and swelling. I would also prescribe hyaluronic acid injection, with the sole purpose of increasing the patient's recovery speed. This drug has previously been used to manage lateral ankle sprain has been associated with fewer side effects, and a significant reduction in pain (Marta & Kawiyana, 2016).
Prescribing
The patient will be prescribed with celecoxib 200 mg, which he will be required to take two times a day (Johns Hopkins, 2012). This dosage will relieve the patient from the pain during the day. The dosage will also reduce the swelling and help him achieve normal activity, including walking and running. The injection will be given in three weeks.
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Possible Side Effects
The patient will be informed that celecoxib has some side effects that are mild and will go away after a few days. These include headache, vomiting, nausea, dizziness, nausea, constipation, and stomach pain. Stomach pain is a severe side effect; hence, the patient will be notified that the drug may cause gastric ulcers or bleeding (Johns Hopkins, 2012). Being a naturally occurring substance, hyaluronic acid injection is exceptionally safe for use ("Hyaluronic acid injections," 2019). A common side effect, however, is allergic reactions.
Age Influence on Decision
The decision to use celecoxib and hyaluronic acid injection was influenced by the patient's age since, at 27, he is an active individual who performs a physical activity, hence has an increased desire to return to work and sporting activities. This is supported by the study by Jako et al. (2015), whose results indicate that hyaluronic acid injection resulted in faster pain relief and return to work.
References
Al-Mohrej, O. A., & Al-Kenani, N. S. (2016). Acute ankle sprain: Conservative or surgical approach? EFORT Open Reviews , 1 (2), 34-44. https://doi.org/10.1302/2058-5241.1.000010
Hyaluronic acid injections . (2019, November 19). Complete Physio. https://complete-physio.co.uk/hyaluronic-acid-injections/
Jako, C., Wirbel, R., & Korner, J. (2015). Influence of Hyaluronic Acid on the Clinical Course of Ankle Sprains. CSMI , 8 (1). https://mdtsa.ch/IMG/pdf/2015_jakobs_hyaluronic_acid_in_ankle_sprains.pdf
Johns Hopkins. (2012, April 25). Celebrex information: Johns Hopkins arthritis center . Johns Hopkins Arthritis Center. https://www.hopkinsarthritis.org/patient-corner/drug-information/celecoxib-celebrex/
Marta, K. K., & Kawiyana, I. K. (2016). Management of acute ankle sprain: A literature review. Indonesia Journal of Biomedical Science , 10 (2), 20. https://doi.org/10.15562/ijbs.v10i2.130
